Online Counselling vs Face-To-Face Therapy: Not Better or Worse, Just Different

Some people make appointments to see their therapist in person, others choose online counselling. As a counsellor and therapist who offers both, my experience is that neither is better or worse than the other, they are just different. Each approach to therapy has its own advantages and benefits.

Do Counsellors Need To See ‘Body Language’?

Some people have an idea that because online counsellors will not see body language, they are at a disadvantage in their job and may not be as effective as face-to-face counsellors. And body language might be important where a counsellor is analysing someone. But psychoanalysis is only one type of counselling. Many counsellors, myself included, are more interested in helping people construct their own meaning rather than imposing meaning.

Online therapeutic conversations actually have the potential to be more focused than a discussion between therapist and client in the same room. The distractions of how someone is sitting, what they are wearing and what else is going on in the room are simply not present during online appointments. A person meeting with a therapist online is often more comfortable than when the consultation is taking place in an unfamiliar office. So working together over the net can increase the effectiveness of the session.

The extra attention that words and language receive when they are conveyed from a position of comfort and in a familiar environment like home can be quite positive aspects of the online counselling experience.

Webcam: Face to Face Counselling over the Internet

The most recognized approach to talk therapy over the Internet is probably webcam counselling. Webcam counselling means that you and the therapist see each other face to face, just like if you were together in the same room. So rather than talk about online counselling and ‘face-to-face’ counselling, I like to use the terms ‘online counselling’ and ‘in-person counselling’, because webcam counselling IS face to face.

There is no doubt many people enjoy the comfort and convenience of meeting a therapist over webcam. You don’t need to think about transport, traffic or what you are wearing. You save time because you don’t even need to leave home. All you need is a functioning computer with webcam, access to the internet and a quiet and private place. You can see and talk with your therapist in confidence and relaxed in your own space. If you don’t want to be seen, you can choose to talk without the video, which is just like telephone counselling.

Instant Messenger Counselling

Different people like the idea of therapy over the Internet for different reasons. The convenience of not having to leave home can be attractive but the privacy and confidentiality of online conversations are also a drawcard for many.

Instant message software such as Skype and Windows Messenger makes it possible to participate in therapy without being seen or heard. Typing out your problems and having your therapist respond with questions or reflections on what you have written can be a refreshing alternative to having to give voice to difficult experiences. This might be quite important for someone who experiences shyness or struggles to speak to a stranger. An additional feature of the software is that it automatically keeps a transcript of the conversation on your computer that you can choose to delete at any time. The advantage here is you can read over the transcript to refresh your memory of what was said after the session has finished and refer to the dialogue at your next appointment if you have any questions. Research has shown that documentation of what transpired can make therapy sessions much more effective.

Email Counselling

Email counselling has been around for some time now. It offers the convenience of not having to leave home, the privacy of not being seen or heard and the added advantage that you can choose to write in your own time.

It can be a big step for someone to start relationship counselling or therapy for a personal problem. Some people feel under time pressure when they are in a room with a therapist. This pressure disappears with email counselling. Exchanging emails with your therapist means you can think through what you want to say, take your time to write it and then, when you receive a reply from the practitioner, you can read it over in your own time. Email counselling takes the rush out of therapy. And everything the therapist says is documented, which is another safeguard for you.

The Benefit of Options in Therapy

I have heard some critics argue that online counselling is a poor substitute for in-person counselling, too risky or even that it should not be legal to practice it.

I have already covered how the different approaches to online therapy have their own advantages that may outweigh ‘body language’ and other specific disadvantages in some situations. In terms of the risks or other concerns, I think it is important to point out that internet based therapy makes counselling and therapeutic support possible for many people who would not otherwise be prepared to engage with a therapist.

A lot of people who have consulted me through online appointments might not have even tried counselling if the online options were not available. Should these people be denied access to counselling just because they are not prepared to sit down in an unfamiliar space with a stranger they have never met?

Online counselling and therapy are inevitably the direction that much therapeutic practice will take in the future. Internet based talk therapy has the potential to help many people because it is comfortable, private and actually does put the consumer back in control.

Thinking about going ahead with online counselling? You can send me an email. I welcome your comments.

About Forward Therapy

Ash Rehn is a counsellor and narrative therapist with over 20 years experience. He specialises in therapeutic conversations and collaborative therapy for anxiety, burnout, depression, midlife crisis, sex and relationship issues, pornography use problems and counselling for lesbians and gay men.